Document Detail

Minor role of ketone bodies in energy metabolism by skeletal muscle tissue during the postoperative course.
MedLine Citation:
PMID:  3276273     Owner:  NLM     Status:  MEDLINE    
To evaluate changes of peripheral ketone body (KB) metabolism after operation, muscle metabolism in postsurgical patients was studied at 3 hours (SI) and 24 hours (SII) after surgery by the forearm catheter technique. Data were compared to those of equivalent fasted controls (CI, CII). In a manner consistent with enhanced mobilization of endogenous substrate stores, arterial concentrations of free fatty acids (FFA), 3-hydroxybutyrate (3-HOB), and acetoacetate (AcAc) were markedly elevated immediately after surgery. This increase was accompanied by a rise in muscular utilization of AcAc (SI: 0.21 +/- 0.05 mumol/100 g/min; CI: 0.08 +/- 0.05, p less than 0.05) and 3-HOB (SI: 0.24 +/- 0.06 mumol/100 g/min; CI: 0.11 +/- 0.01, p less than 0.05). Surprisingly, on the first postoperative day, concentrations of AcAc and 3-HOB fell below those of fasting controls. Concomitantly, the utilization rate of AcAc by muscle (SII: 0.07 +/- 0.03 mumol/100 g/min; CII: 0.27 +/- 0.04, p less than 0.05) was significantly lower in patients than in controls. Reduction of the fractional extraction rate of AcAc (SI: 38.4 +/- 3.8%; SII: 24.0 +/- 6.1%, p less than 0.05), as well as a net production of 3-HOB by muscle (SII: -0.08 +/- 0.05 mumol/100 g/min; CII: 0.49 +/- 0.13, p less than 0.05) 24 hours after surgery indicated a reduced peripheral capacity for KB removal. Since this finding was related to a significantly higher rate of muscular glycerol production (SII: -0.13 +/- 0.03 mumol/100 g/min; CII: -0.06 +/- 0.02, p less than 0.05), one may suggest that increased intramuscular availability of FFA from triglyceride hydrolysis was responsible for the impairment of peripheral KB utilization. These results indicate that KBs contribute little to energy metabolism in skeletal muscle tissue in the late postoperative phase.
W H Hartl; K W Jauch; R Kimmig; M Wicklmayr; B Günther; G Heberer
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of surgery     Volume:  207     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1988 Jan 
Date Detail:
Created Date:  1988-02-05     Completed Date:  1988-02-05     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  95-101     Citation Subset:  AIM; IM    
Department of Surgery, Klinikum Grosshadern, Munich, West Germany.
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MeSH Terms
3-Hydroxybutyric Acid
Acetoacetates / blood,  metabolism
Blood Glucose / analysis
Energy Metabolism
Epinephrine / blood
Fatty Acids, Nonesterified / blood,  metabolism
Glucagon / blood
Glycerol / biosynthesis
Hydroxybutyrates / blood,  metabolism
Insulin / blood
Ketone Bodies / metabolism*
Lactates / blood
Muscles / metabolism*
Norepinephrine / blood
Oxygen / blood
Postoperative Period*
Time Factors
Triglycerides / metabolism
Reg. No./Substance:
0/Acetoacetates; 0/Blood Glucose; 0/Fatty Acids, Nonesterified; 0/Hydroxybutyrates; 0/Ketone Bodies; 0/Lactates; 0/Triglycerides; 11061-68-0/Insulin; 300-85-6/3-Hydroxybutyric Acid; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 541-50-4/acetoacetic acid; 56-81-5/Glycerol; 7782-44-7/Oxygen; 9007-92-5/Glucagon

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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